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1.
PLoS One ; 15(8): e0236029, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760082

RESUMO

Health is a critical factor for the generation of value by workers. Companies bear substantial costs associated with absenteeism and presenteeism among their employees. This study investigates the impact of the environmental conditions in the workplace on the health and job satisfaction of employees, as core factors of productivity. We provide evidence based on a natural experiment, in which 70% of the workforce of a municipality in the Netherlands was relocated to a building with a design focused on sustainability and health and well-being. We construct a longitudinal dataset based on individual surveys of the entire municipality workforce and include measures before and after the move. The estimation results show a significant improvement in the perceived environmental conditions, as well as in the health and well-being of the relocated workers, measured by the drop in incidence of sick building syndrome symptoms. Results are heterogeneous based on age: older groups of employees enjoy larger health impacts. The relocation effects remain persistent in the medium term (two years after the moving date). Importantly, a mediation analysis suggests that the achieved improvements in health and well-being lead to significantly enhanced job satisfaction and a 2% reduction in the prevalence of sick leave.


Assuntos
Arquitetura de Instituições de Saúde , Satisfação no Emprego , Saúde do Trabalhador/economia , Síndrome do Edifício Doente/epidemiologia , Local de Trabalho , Absenteísmo , Adulto , Feminino , Nível de Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Presenteísmo/economia , Presenteísmo/estatística & dados numéricos , Síndrome do Edifício Doente/economia , Licença Médica/economia , Licença Médica/estatística & dados numéricos , Desenvolvimento Sustentável
2.
PLoS One ; 15(6): e0233599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555636

RESUMO

Increasing intensification in swine production has led to new and specialized technologies, but the occupational health and safety impacts are rarely quantified in the business plans for adoption. Needle-less injection has potential to increase productivity and eliminate needle stick injury in workers, but it is not clear whether these benefits offset high capital investment and potential increases in musculoskeletal loads. This economic evaluation employed probabilistic scenario analysis using injury, cost, and production data gathered from interviews with swine producers in Manitoba and Saskatchewan. After adoption of needle-less injection, rates of needle-stick injury went down with no measureable effect on upper limb musculoskeletal disorders, resulting in lower health and safety costs for needle-less injectors. Needle-less injection duration was 40% faster once workers acclimatized, but large start-up costs mean economic benefits are realized only after the first year. The incremental benefit cost ratio promoted adoption of needle-less injectors over conventional needles for the base case of a 1200 sow barn; the conventional method is beneficial for barns with 600 sows or less. Findings indicate that well-designed technologies have the potential to achieve the dual ergonomics goals of enhancing human wellbeing and system performance. We anticipate that the economic and decision models developed in this study can be applied to other new technologies in agriculture and animal production.


Assuntos
Criação de Animais Domésticos/organização & administração , Injeções a Jato/veterinária , Saúde do Trabalhador/economia , Local de Trabalho/organização & administração , Criação de Animais Domésticos/economia , Criação de Animais Domésticos/estatística & dados numéricos , Animais , Análise Custo-Benefício , Eficiência Organizacional , Humanos , Injeções a Jato/economia , Manitoba , Ferimentos Penetrantes Produzidos por Agulha/economia , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/economia , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Saskatchewan , Sus scrofa , Suínos , Doenças dos Suínos/tratamento farmacológico , Doenças dos Suínos/prevenção & controle , Fatores de Tempo , Indenização aos Trabalhadores/economia , Indenização aos Trabalhadores/estatística & dados numéricos , Local de Trabalho/economia
5.
BMC Public Health ; 20(1): 210, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32046683

RESUMO

BACKGROUND: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situations. METHODS: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables affect interventions net benefit. RESULTS: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. CONCLUSIONS: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.


Assuntos
Indústria da Construção , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador/economia , Dióxido de Silício/efeitos adversos , Análise Custo-Benefício/métodos , Humanos , Neoplasias Pulmonares/economia , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/efeitos adversos , Equipamento de Proteção Individual/economia , Probabilidade , Ventilação/economia
6.
Arch Environ Occup Health ; 75(1): 45-55, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30896340

RESUMO

Occupational health in Israel is unique as it was originally established as a socialized service which anchored in extensive legislation and is accessible to all employees and employers without copayment. We review historical processes and legal basis that led to current structure of public occupational medicine services in Israel. Some of these go back a century and others extend way back to biblical times. Representative case studies from the field are used to illustrate its scope of practice. Legislative changes that exempted the employers from participation in financing occupational health have led to severe budget cuts, jeopardizing the future provision and key principles of occupational healthcare. We discuss future aspects of recommended development vectors for policy making that will preserve the structure of occupational health services and benefits it offers to all workers in Israel.


Assuntos
Saúde do Trabalhador/legislação & jurisprudência , Medicina do Trabalho/história , Medicina Estatal/história , História do Século XX , História do Século XXI , Humanos , Israel , Saúde do Trabalhador/economia , Medicina do Trabalho/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência
7.
Cienc. tecnol. salud ; 7(1): 7-25, 2020. ^c27 cmilus
Artigo em Espanhol | LILACS | ID: biblio-1118317

RESUMO

El Centro para la Salud, el Trabajo y el Ambiente (CHWE por sus siglas en inglés) inició un proyecto de colaboración con Pantaleon, una empresa agrícola de caña de azúcar en Guatemala, para hacer frente a una epidemia de enfermedad renal crónica (ERC) de causa no tradicional (ERCnT) que afecta a las comunidades agrícolas en Centroamérica y otros lugares. Este artículo describe el conocimiento actual de la epidemia en Centroamérica, las manifestaciones clínicas, el tratamiento y el manejo; las hipótesis actuales de su etiología, la colaboración y el enfoque de CHWE-Pantaleon. Nuestro enfoque de Total Worker Health® (TWH) para abordar la salud renal en Guatemala incluye múltiples estudios de investigación con trabajadores de caña de azúcar, para evaluar la prevalencia, incidencia y factores de riesgo de la lesión renal aguda y la ERC; se incluye también el desarrollo e implementación de medidas de prevención mejoradas e intervenciones para proteger a los trabajadores abordando los factores de riesgo ya conocidos. Se examinan también las necesidades futuras de investigación y las implicaciones globales de la ERCnT, al igual que la producción de bienes y la economía, así como las recomendaciones actuales para las estrategias de prevención ocupacional y comunitaria.


The Center for Health, Work and Environment (CHWE) began a collaborative project with Pantaleon, a Guatemalan sugarcane agribusiness, to address an epidemic of chronic kidney disease of unknown cause (CKDu) that affects agricultural communities in Central America and elsewhere. This paper describes the current knowledge of the epidemic in Central America including clinical manifestations, course, and management, current etiology hypotheses, and the CHWE-Pantaleon collaboration and approach. Our Total Worker Health® (TWH) approach to addressing kidney health in Guatemala has included multiple research studies with sugarcane workers to assess prevalence, incidence and risk factors for acute kidney injury and chronic kidney disease, as well as development and implementation of enhanced prevention measures and interventions to protect workers by addressing known risk factors. Future research needs and the global implications of CKDu including for economy and commodity production are discussed, as well as current recommendations for occupational and community prevention strategies.


Assuntos
Humanos , Masculino , Feminino , Fatores de Risco , Insuficiência Renal Crônica/prevenção & controle , Trabalhadores Rurais , Saúde do Trabalhador/economia , Insuficiência Renal Crônica/diagnóstico , Lesão Renal Aguda/prevenção & controle , Guatemala/epidemiologia
10.
J Agromedicine ; 24(4): 391-404, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31448696

RESUMO

Objectives: In 2017 the Food and Agriculture Organization (FAO) Committee on Fisheries committed to prioritize occupational safety and health issues in aquaculture (AOSH). An international team was established to synthesize OSH knowledge concerning more than 19 million, often vulnerable, aquaculture workers found globally.Methods: The study was conducted as a desktop scoping exercise using both peer-reviewed and gray literature and the knowledge and expertize of an international panel. Collated information used a standard proforma. Panel members developed draft national and regional AOSH profiles outlining occupational hazards contributing to occupational injuries, diseases, and known solutions. These were work-shopped and refined after gathering additional information and used to compile the first global scoping review report on AOSH.Results: Synthesized results revealed multiple hazards, significant global knowledge gaps and some successful and unsuccessful global, national and industry-specific AOSH policies, practices and standards along the primary supply chain, in marine and freshwater contexts. Some constructive initiatives by the International Labor Organization (ILO) and FAO, industry, labor and civil society groups in a range of employment and geographical settings and across diverse populations of workers were identified.Conclusion: Global commitment to AOSH should be given the same focus as product quality, biosecurity, food safety and environmental sustainability in the sector. This needs development and implementation of integrated AOSH actions appropriate for diverse settings especially in low and middle-income countries encompassing greater uptake of international codes, better risk assessment and OSH management, adoption of technological innovations, effective OSH regulation and enforcement, adequate resources, training and information.


Assuntos
Aquicultura/organização & administração , Saúde do Trabalhador/normas , Acidentes de Trabalho/economia , Acidentes de Trabalho/legislação & jurisprudência , Acidentes de Trabalho/estatística & dados numéricos , Aquicultura/economia , Aquicultura/legislação & jurisprudência , Emprego , Humanos , Renda , Saúde do Trabalhador/economia , Saúde do Trabalhador/legislação & jurisprudência , Traumatismos Ocupacionais/economia , Traumatismos Ocupacionais/epidemiologia
11.
Work ; 64(1): 107-116, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31450534

RESUMO

BACKGROUND: A considerable amount of money is invested annually in workplaces to promote creative, comfortable and safe work environments. The processes and effects of these investments are however not sufficiently studied. OBJECTIVE: The objective of this article is to examine work environment investment processes and identify organizational critical elements for optimizing investment in terms of occupational health and safety effects for employees. METHODS: Twelve case studies were conducted in different sectors. The data was collected through interviews, by studying available documents, and, in several cases, observations and measurement of hazards by means of the PIMEX-method. RESULTS: The empirical results yielded seven different critical elements for work environment investment processes. The critical elements identified were: identifying the need, risk assessment, involvement of staff, consultation with OHS expertise, procurement and delivery, implementation and training of workers, and evaluation. CONCLUSIONS: The critical elements have wide similarities with steps outlined in Swedish Work Environment Management processes, and ideas described in the Plan-Do-Act-Check model. If organizations follow this process, they are provided with improved possibilities for maximizing invested money for a safer working environment.


Assuntos
Saúde do Trabalhador/economia , Local de Trabalho/economia , Acidentes de Trabalho/economia , Acidentes de Trabalho/prevenção & controle , Humanos , Doenças Profissionais/economia , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/economia , Exposição Ocupacional/prevenção & controle , Estudos de Casos Organizacionais , Medição de Risco , Segurança/economia , Local de Trabalho/psicologia
12.
J Agromedicine ; 24(4): 449-461, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31293222

RESUMO

Background: The seafood processing industry is critical to Alaska's economy and hazardous to workers; however, limited research has addressed workers' safety and health. Safety and health program management is a decisive factor in preventing fatalities, injuries, and illnesses. We interviewed managers to gain their views on their safety and health programs.Methods: Semi-structured interviews were conducted with 14 upper-level managers who oversaw programs for Alaskan worksites. Interviews were audio-recorded and transcribed. Qualitative content analysis techniques, including inductive coding, were utilized to explore participants' experiences and views regarding: management and workers' roles; hazard control systems; safety and health training; regulatory and economic factors; and programs' challenges and successes.Results: The 14 participants represented 13 companies that operated 32 onshore plants and 30 vessels with processing capabilities. Participants reported managing programs for an estimated 68% of the Alaskan seafood processing industry's workforce. Based on participants' responses, we identified five factors that could be modified to improve safety and health industry-wide: manager training and knowledge sharing; worker training; organizational aspects related to safety culture; application of ergonomic principles; and work hours. Participants reported that fully engaging workers in programs was beneficial.Conclusions: Industry members should more widely share their best practices for protecting workers' safety and health. Occupational safety and health practitioners and researchers should support the development and evaluation of (a) training for non/limited-English-speaking-workers, (b) ergonomic interventions, and (c) fatigue risk management systems. Future research should engage worksite managers and workers to characterize their safety and health experiences and needs.


Assuntos
Manipulação de Alimentos/normas , Saúde do Trabalhador/normas , Adulto , Alaska , Ergonomia , Estudos de Avaliação como Assunto , Feminino , Manipulação de Alimentos/economia , Promoção da Saúde , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador/economia , Pesquisa Qualitativa , Local de Trabalho/normas
13.
J Agromedicine ; 24(4): 357-363, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31280693

RESUMO

Background: All over the world, commercial fishing is known to be a hazardous occupation. Although several causal analyses of occupational accidents have been published in recent years, knowledge of the prevalence of sick leave, diagnosis and hospitalization among workers on board Norwegian fishing vessels is still sparse.Objective: The objective of this study is to provide new knowledge about the prevalence of doctor-certified sick leave among Norwegian fishers compared to an age- and gender-matched control population. A comparison of diagnoses and hospitalizations between these groups is also presented.Methods: A sample of fishers (n = 25,971) was selected by Statistics Norway (SSB), based on occupation as fishers in 2008-2013. An age- and gender-matched control population (n = 77,913) was also selected. Outpatient consultation and hospitalization data were received from the Norwegian Patient Registry (NPR).Results: Fishers have significantly lower rates of sick leave than the general working population as a whole, but a significantly higher rate sick leave than an age- and gender-matched control population. The most common cause of sick leave in both fishers and controls was musculoskeletal problems. Fishers had a higher number of hospital stays than the control group; the stays were more often unscheduled and lasted longer than those of the control group.Conclusion: The results emphasize the continued need for preventive occupational health strategies in the fishing industry.


Assuntos
Pesqueiros/economia , Hospitalização/estatística & dados numéricos , Doenças Profissionais/terapia , Saúde do Trabalhador/economia , Licença Médica/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Doenças Profissionais/economia , Doenças Profissionais/epidemiologia , Saúde do Trabalhador/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
14.
J Agromedicine ; 24(4): 351-356, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31286849

RESUMO

Researchers involved in community-based participatory research often face challenges due to numerous dynamic factors, including the physical location of the study population, willingness to participate, language barriers, cultural norms, social stigmas, and unpredictable weather and other disasters. Investigators who work with commercial fishermen are all too familiar with these potential obstacles and barriers to performing occupational safety and health research. Such has been the case along the Texas and Louisiana gulf coasts, where the burden of occupational fatalities in the shrimp fishery remains high. Moreover, the need for strategic community, regulatory agency, and research partnerships in order to explore solutions that can help to reduce this burden is ongoing. The IFISH 5 conference and the panel session described in this brief report offered a venue to acknowledge and create awareness of these barriers and opportunities for developing sustainable solutions that can have an impact on this loss of life. The approach taken was to explore the perspectives of a panel of regional collaborators including two researchers, an outreach community liaison, and a marine safety and health official from the U. S. Coast Guard. Key barriers emerging from the panel fell into four themes, each emphasized by one of the four panel members, allowing for discussion of potential solutions. The themes included: (1) language gap; (2) cultural influences and use of personal flotation devices; (3) relationships with the community; and (4) enforcement agency role as a trusted opinion leader. This panel session can readily serve as a model to promote similar exploration of barriers and solutions in commercial fishing across other regions of the US and internationally as well.


Assuntos
Pesqueiros/normas , Saúde do Trabalhador/estatística & dados numéricos , Pesquisa Participativa Baseada na Comunidade , Cultura , Pesqueiros/economia , Golfo do México , Humanos , Louisiana , Saúde do Trabalhador/economia , Equipamentos de Proteção/normas , Texas
16.
J Occup Environ Med ; 61(7): 597-604, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31022100

RESUMO

OBJECTIVE: The purpose of this paper is to describe and evaluate a web-based, educational Health Risk Calculator that communicates the value of investing in employee health and well-being for the prevention of work-related injuries, illnesses, and fatalities. METHODS: We developed and evaluated the calculator following the RE-AIM framework. We assessed effectiveness via focus groups (n = 15) and a post-use survey (n = 33) and reach via website analytics. RESULTS: We observed evidence for the calculator's usability, educational benefit, and encouragement of action to improve worker health and safety. Website analytics data demonstrated that we reached over 300 users equally in urban and rural areas within 3 months after launch. CONCLUSION: We urge researchers to consider the ways in which they can communicate their empirical research findings to their key stakeholders and to evaluate their communication efforts.


Assuntos
Promoção da Saúde/economia , Doenças Profissionais/economia , Serviços de Saúde do Trabalhador/economia , Saúde do Trabalhador/economia , Traumatismos Ocupacionais/economia , Indenização aos Trabalhadores/estatística & dados numéricos , Adolescente , Adulto , Idoso , Colorado/epidemiologia , Feminino , Grupos Focais , Humanos , Incidência , Internet , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/etiologia , Traumatismos Ocupacionais/prevenção & controle , Medição de Risco , Indenização aos Trabalhadores/economia , Adulto Jovem
17.
BMC Public Health ; 19(1): 348, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-30922285

RESUMO

BACKGROUND: Musculoskeletal pain (MSP) is the leading cause of years lived with disability. In consequence, to reduce MSP and its associated sickness absence is a major challenge. Previous interventions have been developed to reduce MSP and improve return to work of workers with MSP, but combined approaches and exhaustive evaluation are needed. The objective of the INTEVAL_Spain project is to evaluate the effectiveness of a multifaceted intervention in the workplace to prevent and manage MSP in nursing staff. METHODS: The study is designed as a two-armed cluster randomized controlled trial with a late intervention control group. The hospital units are the clusters of randomization and participants are nurses and aides. An evidence-based multi-component intervention was designed combining participatory ergonomics, case management and health promotion. Both the intervention and the control groups receive occupational health care as usual. Data are collected at baseline, and after six and 12 months. The primary outcomes are prevalence of MSP and incidence and duration of sickness absence due to MSP. Secondary outcomes are work role functioning and organizational preventive culture. The intervention process will be assessed through quantitative indicators of recruitment, context, reach, dose supplied, dose received, fidelity and satisfaction, and qualitative approaches including discussion groups of participants and experts. The economic evaluation will include cost-effectiveness and cost-utility, calculated from the societal and the National Health System perspectives. DISCUSSION: Workplace health programs are one of the best options for the prevention and control of non-communicable diseases. The main feature of this study is its multifaceted, multidisciplinary and de-medicalized intervention, which encompasses three evidence-based interventions and covers all three levels of prevention, which have not been previously unified in a single intervention. Also, it includes a comprehensive quantitative and qualitative evaluation of the intervention process, health results, and economic impact. This study could open the possibility of a new paradigm for the prevention and management of MSP and associated sickness absence approach at the workplace. TRIAL REGISTRATION: Current Controlled Trials ISRCTN15780649 Retrospectively registered 13th July 2018.


Assuntos
Dor Musculoesquelética/prevenção & controle , Recursos Humanos de Enfermagem no Hospital , Saúde do Trabalhador , Análise Custo-Benefício , Seguimentos , Humanos , Saúde do Trabalhador/economia , Projetos de Pesquisa , Espanha , Inquéritos e Questionários
18.
BMC Public Health ; 19(1): 268, 2019 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-30894160

RESUMO

BACKGROUND: Attracted by the expected benefits such as reduced absenteeism and increased productivity, more and more firms decide to implement workplace health promotion programs (WHPPs). However, those programs can only be effective if employees actually participate. This study aims to (1) gain insight into the degree of enrolment rates in such programs across companies and (2) identify organizational level factors that are associated with employee participation. Building on existing theory on organizational drivers of participation in corporate wellness programs, the study's main goal is to investigate which organizational factors determine whether employees enroll in a corporate fitness program or not. METHODS: A business-to-business fitness platform company provided organizational level data on 61 client firms that have recently implemented a corporate wellness program. The data contained information on the enrolment rate per company and different organizational level variables. The following potential determinants of participation were analyzed: firm size, organizational program support and employee co-payment. A random effects model was used to examine associations between potential determinants and the program enrolment rate. RESULTS: The average participation is limited (15.37%) but varies highly across companies (range 0.07-100.00%, monthly basis). Looking at the determinants of program enrolment, we find that organizational program support - the degree to which firm leadership encourages participation - positively influences the enrolment rate (ß = 0.051 p < 0.001) while employee co-payment - the financial contribution employees have to make to participate - has a negative impact (ß = - 0.002, p < 0.001). Furthermore, firm size has a negative relationship with firm enrolment. CONCLUSIONS: Enrolment rates in WHPPs are limited, as many companies have difficulties to promote participation in WHPPs among employees. Strong organizational program support and low employee co-payment were identified as drivers of employee participation in corporate health programs. Hence, intensifying both social and financial support of employee participation may help to drive enrolment rates. Firm size was found to negatively affect the enrolment rate in WHPPs, implying that larger firms have to account for their size and corresponding complexity when implementing such a program.


Assuntos
Saúde do Trabalhador , Engajamento no Trabalho , Local de Trabalho/organização & administração , Apoio Financeiro , Humanos , Saúde do Trabalhador/economia , Cultura Organizacional , Avaliação de Programas e Projetos de Saúde , Apoio Social
19.
Artigo em Inglês | MEDLINE | ID: mdl-30866495

RESUMO

OBJECTIVES: To assess the cost-effectiveness of workplace-delivered interventions designed to reduce sitting time as primary prevention measures for cardiovascular disease (CVD) in Australia. METHODS: A Markov model was developed to simulate the lifetime cost-effectiveness of a workplace intervention for the primary prevention of CVD amongst office-based workers. An updated systematic review and a meta-analysis of workplace interventions that aim to reduce sitting time was conducted to inform the intervention effect. The primary outcome was workplace standing time. An incremental cost-effectiveness ratio (ICER) was calculated for this intervention measured against current practice. Costs (in Australia dollars) and benefits were discounted at 3% annually. Both deterministic (DSA) and probabilistic (PSA) sensitivity analyses were performed. RESULTS: The updated systematic review identified only one new study. Only the multicomponent intervention that included a sit-and-stand workstation showed statistically significant changes in the standing time compared to the control. The intervention was associated with both higher costs ($6820 versus $6524) and benefits (23.28 versus 23.27, quality-adjusted life year, QALYs), generating an ICER of $43,825/QALY. The DSA showed that target age group for the intervention, relative risk of CVD relative to the control and intervention cost were the key determinants of the ICER. The base case results were within the range of the 95% confidence interval and the intervention had a 85.2% probability of being cost-effective. CONCLUSIONS: A workplace-delivered intervention in the office-based setting including a sit-and-stand desk component is a cost-effective strategy for the primary prevention of CVD. It offers a new option and location when considering interventions to target the growing CVD burden.


Assuntos
Doenças Cardiovasculares/economia , Doenças Cardiovasculares/prevenção & controle , Saúde do Trabalhador/economia , Postura Sentada , Local de Trabalho/economia , Austrália , Análise Custo-Benefício , Humanos , Cadeias de Markov , Modelos Econômicos , Prevenção Primária , Anos de Vida Ajustados por Qualidade de Vida , Posição Ortostática , Fatores de Tempo
20.
J Occup Environ Med ; 61(7): 535-544, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30870396

RESUMO

OBJECTIVE: This study investigates the associations between Effort-Reward-Imbalance (ERI), Overcommitment (OC), Job-Demand-Control (JDC), and Organizational Injustice (OIJ) with employee well-being, absenteeism, and presenteeism, as well as the costs incurred. METHODS: Cross-sectional data from 1440 German pharmaceutical company employees assessing job stress, employee well-being, absenteeism, and presenteeism were used. Linear regression and interval regression analyses assessed separate and independent associations and sample-specific costs were estimated. RESULTS: All four stressors were related to employee well-being, presenteeism, and absenteeism when analyzed separately. OIJ showed the strongest independent association with absenteeism (coef. = 0.89; P < 0.01), whereas OC was most strongly independently associated with lower well-being (coef. = -0.44; P < 0.01) and higher presenteeism (coef. = 0.28; P < 0.01). Absenteeism costs per employee/year were higher than presenteeism costs. CONCLUSIONS: Occupational health interventions reducing job stress will have strong potential for productivity raise and lower costs.


Assuntos
Modelos Psicológicos , Estresse Ocupacional , Absenteísmo , Adulto , Estudos Transversais , Indústria Farmacêutica/economia , Feminino , Alemanha , Inquéritos Epidemiológicos , Humanos , Controle Interno-Externo , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador/economia , Estresse Ocupacional/economia , Estresse Ocupacional/psicologia , Presenteísmo/economia , Recompensa , Justiça Social
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